Pacific Islands Action Plan
Pacific Islands Action Plan
on Climate Change and Health
This Action Plan is a product of the Meeting to Develop the Pacific Action
Plan for the WHO Initiative on Climate Change and Health in Small Island
© World Health Organization 2018 ISBN 978 92 9061 864 5
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Cataloguing-in-Publication (CIP) data
. 1. Climate change. 2. Pacific islands. 3. Strategic planning. I. World Health Organization Regional Office for the Western Pacific. (NLM Classification: WA30.2)
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1. Background 1
2. Current Situation in the Pacific 2
3. Action Plan 2019–2023 4
3.1 Goal 4
3.2 Strategic Lines of Action 4
3.2.1 Strategic Line of Action 1: Empowerment
Supporting health leadership in PICs to engage nationally and internationally
5
3.2.2 Strategic Line of Action 2: Evidence
Building the health argument for investment 8
3.2.3 Strategic Line of Action 3: Implementation
Preparing for climate risks, building climate-resilient health systems and developing health-promoting mitigation policies
11
3.2.4 Strategic Line of Action 4: Resources
Facilitating access to climate and health finance 14
Contents
Foreword v
Dr Joy St John
Assistant Director-General
Climate and Other Determinants of Health World Health Organization
Geneva, Switzerland
Shin Young-soo, MD, Ph.D.
Regional Director
World Health Organization/Western Pacific Region Manila, Philippines
Foreword
Climate change threatens health everywhere. Populations around the world are more frequently and intensely affected by extreme weather events, threats to food and water security, outbreaks of waterborne and vector-borne diseases, and the increased pressure on scarce resources triggering climate-related migration and conflicts.
Nowhere can these threats lead to more serious consequences than in the Pacific island countries and areas (PICs). The combination of extreme exposure to climate-related disasters (e.g.
cyclones, floods, droughts) and long-term sea level rise, coupled with geographically dispersed populations in remote small islands with fragile health systems, means that climate change is an existential threat to the Pacific islanders.
For this reason, WHO started working with PICs from the year 2000, to develop national climate change and health action plans based on the vulnerability and capacity assessments of most Pacific nations.
With WHO support, the most vulnerable countries in the Pacific are currently developing large-scale five-year projects to build climate-resilient health systems.
In recent years, the voice of the Pacific leaders has become even more ardent with increasing force and urgency. The right to health in the face of climate change, and the particular vulnerabilities of the Small Island Developing States (SIDS) were recognized in the Paris Agreement in 2015. The World Health Assembly and the Regional Committee for the Western Pacific have prioritized the health impacts of climate change, including through Western Pacific Regional Framework for Action on Health and Environment on a Changing Plane t (2016).
In January 2018, the 142nd session of the WHO Executive Board endorsed “health impacts of climate and environmental change in SIDS and Vulnerable States” as one of the top priorities of WHO work for the period 2019–2023.
Under the leadership of Director-General Dr Tedros, the Special Initiative on Climate Change and Health in SIDS was launched in November 2017 by WHO in partnership with the Secretariat of the United Nations Framework Convention on Climate Change (UNFCCC) and the Government of Fiji, as President of the 23rd Conference of the Parties to the UNFCCC. To develop this SIDS Initiative, WHO convened the Meeting to Develop the Pacific Action Plan for the WHO Initiative on Climate Change and Health in Small Island Developing States (PICs Consultation Meeting) in Nadi, Fiji in March 2018.
This Pacific Islands Action Plan is the outcome of the PICs Consultation Meeting. It will be part of the global action plan that is being prepared by WHO through a series of regional consultations throughout 2018. This Action Plan presents the short-term (by 2021) and long-term (2023) action items and indicators of the four areas of work of the SIDS Initiative. Through the implementation of this Action Plan, PICs will benefit from the highest-quality and greatest possible political, technical and financial support in protecting Pacific islanders from climate-sensitive diseases and building climate-resilient health systems.
The PICs’ contribution to the emission of greenhouse gas is negligible. Nevertheless, they are the first ones affected by the impacts of climate change. For that reason, while implementing this Action Plan with PICs, WHO will strongly promote the low-carbon global development path to stop climate change and guarantee the future of the Pacific islands.
On behalf of WHO, we are proud to work with the PICs to implement this plan of action in the coming years
to protect the health of Pacific islanders from the impacts of climate change.
The Small Island Developing States (SIDS) Initiative on Climate Change and Health has a vision that by 2030 all health systems in SIDS will be resilient to climate variability and change. The Initiative envisions that building resilience must happen in parallel with countries around the world reducing carbon emissions in order to protect the most vulnerable from climate risks and to gain the health co-benefits of mitigation policies.
The notion that “the future will assess us not just on what we did, but also on what we failed to do”
inspires us to take action to protect the health of our most vulnerable populations. The emphasis on SIDS is opportune, considering the continuing exposure of their fragile ecosystems to increasing intensity and frequency of natural disasters and the impacts these extreme events have on their health systems.
For more than two decades, WHO has been proactive in creating awareness and implementing actions to manage the health risks of climate change within Member States. Ministers of health and high-level representatives have acknowledged the adverse impacts of climate change on the health of vulnerable populations. In November 2017, the SIDS Initiative on Climate Change and Health was launched by WHO at the 23rd Conference of the Parties to the United Nations Framework Convention on Climate Change in Bonn, Germany.
The Pacific island countries and areas discussed how to work together for implementation of the above SIDS Initiative at the Meeting to Develop the Pacific Action Plan for the WHO Initiative on Climate Change and Health in SIDS, organized by WHO as part of the Third Global Conference on Climate Change and Health in Nadi, Fiji, on 15–16 March 2018. At the Meeting, country representatives from health, environment and climate change reviewed a background document, Climate Change and Health in Small Island Developing States: Pacific Island Countries, prepared by the WHO Secretariat, taking into account:
existing Pacific initiatives such as the Healthy Islands vision of the Yanuca Island Declaration; the report of the 12th Pacific Health Ministers Meeting, held in Rarotonga, Cook Islands on 28–30 August 2017; the Western Pacific Regional Framework for Action on Health and Environment on a Changing Planet; the SIDS Accelerated Modalities of Action (SAMOA) Pathway; and the Sustainable Development Goals.
Climate change is the greatest threat to health and health systems of Pacific island countries and areas in the 21st century. However, we believe that it can be the greatest opportunity for us to build climate- resilient health systems through our determined actions. The Pacific Islands Action Plan will bring communities and stakeholders together to ensure that by 2030 all health systems in the Pacific will be resilient to climate variability and change.
Honourable Nandi Glassie
Minister for Health, Justice and Parliamentary Services, Cook Islands Chair of the 12th Pacific Health Ministers Meeting
May 2018
vi
Foreword
Since the adoption of the United Nations Framework Convention on Climate Change (UNFCCC) in 1992, protecting “human health and welfare” has been recognized as a priority in responding to climate change. The Paris Agreement recognizes “the right to health”, presenting the opportunity to implement the Agreement as a public health treaty. This is particularly relevant to Small Island Developing States (SIDS), which have made minimal contribution to global carbon emissions but are among the most susceptible countries to climate change impacts.
In 2017, at the 23rd Conference of the Parties (COP23) to the UNFCCC in Bonn, WHO launched a Special Initiative on Climate Change and Health in SIDS, in collaboration with UNFCCC and the Fijian Presidency of the COP23. The Initiative recognizes that SIDS are in the front line facing a range of acute and long- term risks, including extreme floods, storms, drought and sea level rise, and increased risks of water-, vector- and food-borne diseases.
The Initiative aims to provide national health authorities in SIDS with the political, technical and financial support, as well as the evidence:
• to better understand and address the effects of climate change on health, including those mediated via climate change impacts on the main determinants of health (e.g. food, air, water and sanitation and vectors);
• to improve the climate resilience and environmental sustainability of health services; and
• to promote the implementation of climate change mitigation actions by the most polluting sectors (e.g. transport, energy, food and agriculture) that maximize health co-benefits, both within and outside SIDS.
The Initiative will also aim to lead the way in transforming health services in SIDS away from a model of curative services with escalating costs and towards one based on disease prevention, climate resilience and sustainability. It will also implement approaches for WHO to work in a more integrated way both across its own programmes (e.g. environmental health, workers’ health, health systems strengthening, emergency preparedness and response, food security, and nutrition) and with other partners.
This Action Plan is for the period 2019–2023 and corresponds to the implementation of the WHO Special Initiative on Climate Change and Health in SIDS for Pacific island countries in the WHO Western Pacific Region.
1. Background
The first Ministerial Conference on Health for the Pacific Island Countries in 1995 resulted in the Yanuca Island Declaration, with a vision of “Healthy Islands” as the unifying theme for health promotion and health protection, noting that “Healthy Islands are places where children are nurtured in body and mind; environments invite learning and leisure; people work and age with dignity; ecological balance is a source of pride; and the ocean which sustains us is protected (added in 1999) "
During the 11th Pacific Health Ministers Meeting in 2015, ministers renewed their commitment to this vision. Participants acknowledged important progress in child survival and life expectancy, but with gains that are unequal among countries and with a significant gap between Pacific island countries and the rest of the world. Ministers agreed to implement the Healthy Islands vision in four thematic areas:
•
strengthening leadership, governance and accountability;
•
nurturing children in body and mind;
•
reducing avoidable disease burden and premature deaths; and
•
promoting ecological balance.
The 12th Pacific Health Ministers Meeting in 2017 noted that while many ministers of health actively voice their concerns regarding the health risks of climate change, programmes and projects to build resilience and strengthen health systems to prepare for and manage the health risks of climate change could not be pursued because of lack of funding, due to the complexity of navigating the processes to access international and bilateral funds. National and health sector budget allocations for climate change have been minimal or absent, in part due to issues such as insufficient data and limited sharing of results from evidence-based interventions.
The SIDS Initiative is fully aligned with the Western Pacific Regional Framework for Action on Health and Environment on a Changing Planet , which has four areas of strategic actions:
•
Governance and leadership – enhancing governance and leadership for stronger environmental health capacity.
•
Communication – making scientific evidence easily accessible and available to the public through communications, advocacy and social mobilization.
•
Networks, coalitions and alliances – establishing or strengthening existing regional, national and local networks, and communities of practice on health and the environment.
•
Strategic financing and resource mobilization – ensuring adequate resources for environmental health.
2. Current Situation in the Pacific
2
Many countries are engaging in the WHO–UNFCCC Climate and Health Country Profile Project, which aims to raise awareness of the health impacts of climate change, support evidence-based decision- making to strengthen the climate resilience of health systems, and promote actions that improve health while reducing carbon emissions. This is a valuable tool to track country progress on actions addressing climate change and health.
The SIDS Initiative and its implementation in the Pacific intends to support and strengthen current
initiatives such as the actions to achieve the Sustainable Development Goals and Healthy Islands. The
SIDS Initiative is aligned with these in terms of objectives, indicators and time frames.
This Pacific Islands Action Plan on Climate Change and Health for the SIDS was developed during the Meeting to Develop the Pacific Action Plan for the WHO Initiative on Climate Change and Health in SIDS, organized as part of the Third Global Conference on Climate Change and Health held in Nadi, Fiji on 15–16 March 2018. Participants included delegates from the health sectors and climate change sectors of the Commonwealth of the Northern Mariana Islands, Cook Islands, the Federated States of Micronesia, Fiji, French Polynesia, Guam, Kiribati, the Marshall Islands, Nauru, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu and Vanuatu.
3.1 Goal
The SIDS Initiative has a goal that by 2030 all health systems in SIDS will be resilient to climate variability and change.
This must happen in parallel with countries around the world reducing carbon emissions, both to protect the most vulnerable from climate risks and to gain the health co-benefits of mitigation policies.
3.2 Strategic Lines of Action
The SIDS Initiative has four strategic lines of action, to be implemented in the period 2019–2023:
a) Empowerment: Supporting health leadership in PICs to engage nationally and
internationally.b) Evidence: Building the business case for investment.
c) Implementation: Preparing for climate risks, building climate-resilient health
systems and developing health-promoting mitigation policies.d) Resources: Facilitating access to climate and health finance.
For each strategic line of action, this Action P lan proposes indicators, actions and targets for monitoring progress of relevance to Pacific island countries and areas.
3. Action Plan 2019–2023
4
_____________________________________________________________________________________________
3.2.1 Strategic Line of Action 1: Empowerment
Supporting health leadership in PICs to engage nationally and internationally
Health is increasingly recognized in climate discussions; nevertheless, it is still not routinely recognized as a priority – missing opportunities both to protect health and to mobilize health as an argument and success measure for climate action. There is a need for concrete actions to ensure the health argument is effectively incorporated into the official positions of SIDS groupings in global UNFCCC negotiations. The SIDS Initiative aims to address this through the Line of Action on Empowerment.
A measure of success is that the voice of health leaders, on behalf of the most vulnerable populations, becomes a driving force for adaptation in SIDS, and for mitigation in countries around the world.
National actions
Short term (by 2021)
Action N.1.1 Support ministry of health engagement with the UNFCCC process and related forums, and participate in the national adaptation plans (NAPs) and similar processes – for example, nationally determined contributions – to include health (H-NAP).
Action N.1.2 Identify, develop and encourage civil society organizations and nongovernmental organizations to be engaged in the climate change and health agenda, to better reach communities and implement action, considering their independence and flexible communication protocols.
Long term (by 2023)
Action N.1.3 Ensure SIDS health leaders are well informed on the latest science and literature with compelling evidence regarding the relationship between climate change and health, and are empowered to highlight the threats climate change poses on health in national statements during high-level engagements.
Action N.1.4 Establish joint collaborative and coordination activities between health and other sectors and institutions, such as in capacity-building and evidence-based research activities, and joint action plans.
Pacific Islands Action Plan on Climate Change and Health
Proposed actions
6
Pacific Islands Action Plan on Climate Change and Health
Regional and global actions
Short term (by 2021)
Action R.1.1 Ensure high-level engagement by including the SIDS Initiative in the ongoing agendas of the Pacific Health Ministers Meeting and the Asia-Pacific Regional Forum on Health and Environment, and in UNFCCC SIDS groupings, including the Alliance of Small Island States (AOSIS) and G77+China.
Action R.1.2 Include, in current regional mechanisms, terms of reference and strategies to keep the health sector engaged on the climate change agenda at all times, and to ensure that the climate change and health agenda is active in all related regional frameworks.
Long term (by 2023)
Action R.1.3 Incorporate health into regional climate change frameworks and incorporate climate change into regional health frameworks.
Action R.1.4 Incorporate climate change and health as a standing agenda for the Pacific Climate Change Roundtable (PCCR), the Council of Regional Organisations in the Pacific (CROP), the Framework for Resilient Development in the Pacific (FRDP) and other regional groupings.
Action R.1.5 Establish, within current regional frameworks, a capacity-building mechanism to support countries to ensure that all national investments in health consider climate resilience.
Action R.1.6 Identify appropriate forums and mechanisms to ensure the Pacific voice is unified, amplified and heard in promoting mitigation actions among the most polluting countries.
Supporting actions
Action S.1.1 Empower, train and support environmental health officers and other
relevant health workers through their respective national and regional associations, to
address climate change and health issues.
Core
Indicator C.1.1 Number of countries reporting to the Pacific Health Ministers Meeting on progress in the implementation of the SIDS Initiative in the Pacific.
Indicator C.1.2 Number of countries where the health minister or permanent secretary participates in the Conference of the Parties to the UNFCCC.
Proposed indicators
_____________________________________________________________________________________________
3.2.2 Strategic Line of Action 2: Evidence Building the health argument for investment
Significant financial resources are potentially available from international climate financing mechanisms, development banks and others to build resilient health systems. However, the health sector in general, and SIDS in particular, lack the systematic economic evidence base that is necessary to make their case to potential investors. Knowledge of the interlinkages between climate change and health in SIDS is limited and needs to be increased and constantly improved through research. Capacity to undertake research in the area of climate change and health in SIDS needs to be strengthened. The SIDS Initiative aims to address this through the Line of Action on Evidence.
A measure of success is that health ministries have the necessary health, environment and economic evidence to support scaled-up investment in climate change and health, identify priority investments and monitor their impact.
National actions
Short term (by 2021)
Action N.2.1 Ensure that vulnerability and adaptation assessments and profiles for each country use a standardized approach, thus allowing for comparisons and sharing of methods and information, building on intraregional cooperation.
Long term (by 2023)
Action N.2.2 Develop tools to obtain comparable data for planning, economic evaluations and benefit estimates for building resilient health systems to support funding proposals.
Action N.2.3 Develop detailed investment plans informed by sound economic analyses, inclusive of existing resources, costs and gaps to increase resilience of health-care facilities.
Action N.2.4 Assess and estimate the cost of climate change impacts on health.
Proposed actions
8
Regional and global actions
Short term (by 2021)
Action R.2.1 Identify, support and build on existing centres of excellence for increasing capacity, conducting assessments, data analysis and research, and implementing actions, including with organizations and universities that have regional mandates.
Action R.2.2 Implement a knowledge-sharing hub to provide health information and statistics on climate change and health for Pacific island countries and areas.
Action R.2.3 Create a regional mechanism for WHO and the health sector to work with existing projects or entities such as the Secretariats of the Pacific Regional Environment Programme (SPREP) and the Pacific Community (SPC).
Action R.2.4 Implement a regional climate and health information and research system allowing countries to have up-to-date WHO–UNFCCC Climate and Health Country Profiles, shared regionally together with all relevant climate change and health research .
Action R.2.5 Produce a regional roadmap that serves as an evidence base and prepare guidance to monitor and evaluate the effectiveness of designated priorities.
Action R.2.6 Integrate climate change and health data in existing information systems such as the Pacific Public Health Surveillance Network (PPHSN) and the Pacific Climate Change Portal (PCCP).
Supporting actions
Action S.2.1 Ensure that both the health and climate change sectors achieve a common understanding of issues and key concepts of joint interest.
Action S.2.2 Develop and strengthen curricula and other coursework for education in primary, secondary and tertiary institutions.
Action S.2.3 Build capacity to strengthen operational research and engagement of
academic institutions at the national and regional levels (e.g. through memoranda of
understanding between ministries and academic institutions).
Action S.2.4 Establish agreed-upon standards on the reporting of climate change and health risks and/or climate-sensitive diseases, building and linking with existing institutional arrangements.
Action S.2.5 Collaborate with academic institutions to generate and provide evidence and policy-relevant advice.
Action S.2.6 Use existing research journals as a regional platform to generate and share evidence on climate change and health.
Action S.2.7 Support the establishment of, or link to, an existing research hub with a clearly defined climate change and health research agenda.
Core
Indicator C.2.1 Number of countries with completed Climate and Health Country Profiles.
Indicator C.2.2 Number of countries with updated National Climate Change and Health Action Plan (NCCHAP) or H-NAP.
Extended
Indicator E.2.1 Number of country reports on climate change and health investment strategies prepared and shared regionally.
Proposed indicators
10
_____________________________________________________________________________________________
3.2.3 Strategic Line of Action 3: Implementation
Preparing for climate risks, building climate-resilient health systems and health-promoting mitigation policies
The SIDS Initiative will build on the experience gained in climate and health adaptation projects around the world, applying WHO’s Operational Framework for Building Climate-Resilient Health Systems. The SIDS Initiative aims to strengthen the role of the health sector in promoting health co-benefits of climate change mitigation actions. The SIDS Initiative aims to address this through the Line of Action on Implementation.
A measure of success is that transformational change in health systems is implemented through promoting a culture of disease prevention, building the climate resilience of health systems and maximizing the health co-benefits of climate change mitigation policies.
National actions
Short term (by 2021)
Action N.3.1 Support the WHO–UNFCCC Climate and Health Country Profile Project as the mechanism for the implementation and monitoring of this Plan of Action.
Action N.3.2 Support training to build awareness and knowledge of the UNFCCC agreements, including the Paris Agreement, for the ministry of health.
Action N.3.3 Develop and implement programmes and training to promote the transition to a culture of disease prevention both by people and by the health system.
Action N.3.4 Conduct baseline assessment and develop mitigation plans to reduce greenhouse gas (GHG) emissions from energy, food, transportation and procurement within the health sector.
Action N.3.5 Promote an enabling environment to identify and update climate change and health–related policies, standards and legislation.
Proposed actions
Long term (by 2023)
Action N.3.6 Strengthen environmental health programmes to cover preventive health services and primary health care, including disaster risk management and communicable and noncommunicable diseases, including mental health.
Action N.3.7 Integrate safe and green hospital (and health-care facilities) following a standardized framework in all countries, adopting and implementing a “Safe + Green = SMART” concept for health services and facilities at the national level.
Regional and global actions
Short term (by 2021)
Action R.3.1 Strengthen current regional frameworks to support countries to implement actions to build climate-resilient health systems.
Long term (by 2023)
Action R.3.2 Support a regional hub that establishes a platform for SIDS to implement national health adaptation plans with aims to promote information sharing, stocktaking and research.
Action R.3.3 Conduct advocacy and awareness campaigns for leaders, policy-makers and key stakeholders through a “one-stop shop” or knowledge management hub.
Supporting actions
Action S.3.1 Strengthen the capacity of the health sector to respond effectively to climate-sensitive diseases.
Action S.3.2 Ensure that all construction and reconstruction work in the health sector is done at the highest standards, ensuring resilience in the face of climate risks.
Action S.3.3 Develop a regional training module on climate change and health through a regional mechanism (e.g. via the Pacific Open Learning Health Net).
12
Core
Indicator C.3.1 Number of countries implementing actions towards building climate- resilient health systems.
Indicator C.3.2 Number of countries engaged in the WHO–UNFCCC Climate and Health Country Profile Project.
Indicator C.3.3 Number of countries with a climate change and health focal point.
Extended
Number of projects funded and implemented for building climate-resilient Indicator E.3.1
health systems.
Indicator E.3.2 Number of countries implementing water, sanitation and hygiene (WASH) in health-care facilities for climate-resilient health systems.
Number of countries implementing SMART (safe and green) health Indicator E.3.3
facilities initiatives.
Proposed indicators
_____________________________________________________________________________________________
3.2.4 Strategic Line of Action 4: Resources
Facilitating access to climate and health finance
A significant change in current health vulnerability of the populations of SIDS will not be possible without access to sufficient financial resources. Ministers of health have prioritized the need to expand and diversify the funding streams potentially available to build health resilience to climate change. The SIDS Initiative aims to address this through the Line of Action on Resources.
A measure of success is to triple the current level of investment of climate finance for health in SIDS.
National actions
Short term (by 2021)
Action N.4.1 Strengthen national leadership, advocacy and mechanisms to establish a clear process to access climate change and health financing.
Action N.4.2 Implement mechanisms with development partners to overcome current complexities in accessing funds by building capacity of in-country focal points and advocating greater simplification and transparency in the process.
Long term (by 2023)
Action N.4.3 Identify and address data needs, knowledge gaps and coordination mechanisms to develop sound proposals to access funds, considering that there are other competing national priorities targeting the same funding sources.
Regional and global actions
Short term (by 2021)
Action R.4.1 Explore regional opportunities to increase access to funds while advocating for the health sector to be a direct recipient of climate funds.
Action R.4.2 Support accreditation of WHO for the Global Environment Facility (GEF) and the Green Climate Fund (GCF).
Proposed actions
14
Long term (by 2023)
Action R.4.3 Ensure WHO and development partners facilitate access to funding to address the action plan and indicators.
Supporting actions
Action S.4.1 Identify and engage existing funding mechanisms (e.g. PCCR, SPREP, CROP and national donor roundtables) to include climate change and health risks.
Action S.4.2 Collaborate with academic institutions to develop regional in-country training courses specifically to address climate change and health, including research.
Action S.4.3 Establish a regional technical support group that focuses on accessing climate change and health funding, and to develop institutional capacity to support the process of proposal development.
Action S.4.4 Identify focal points for regional financial institutions and utilize existing funding mechanisms to access funding through the national focal points.
Core
Indicator C.4.1 Number of countries with existing national mechanisms for the health sector to access climate finance.
Proposed indicators
Extended